SnackableHealth™ | Short-CUT: Intravascular Lithotripsy Outperforms Cutting Balloon in Managing Calcified Coronary Lesions

In this SnackableHealth™ session from TCT 2025, Dr. Suzanne J. Baron and Dr. C. Michael Gibson examined the findings of the Short-CUT trial, which directly compared intravascular lithotripsy (IVL) with cutting balloon angioplasty in patients with moderate-to-severe coronary calcification.

Dr. Baron emphasized that managing calcified lesions remains one of the most challenging aspects of PCI, as rigid plaques can hinder optimal stent expansion and long-term patency. “Traditional cutting balloons are effective for surface modification but often fall short in deeper calcium fractures,” she explained.

The Short-CUT trial demonstrated that IVL achieved superior procedural success, with greater luminal gain and fewer dissections or vessel injuries compared to cutting balloon angioplasty. The mechanism of IVL—emitting controlled acoustic pressure waves to fracture both superficial and deep calcium—resulted in more uniform plaque modification and smoother stent delivery.

Dr. Gibson highlighted the broader clinical relevance: “IVL continues to show consistent safety and efficacy across lesion types. The Short-CUT data reaffirm its role as a versatile tool, especially when other devices cannot adequately prepare calcified vessels.”

Both experts agreed that IVL’s reproducibility and safety profile position it as a preferred approach in the treatment algorithm for calcified coronary disease, particularly as operators seek to minimize vessel trauma while ensuring optimal stent expansion.